<div id="page">
<div class="page-title" style="z-index: 780;">
	<div class="in" style="z-index: 770;">
			<div class="titlebar" style="z-index: 760;">	<h2>Add Customer</h2> <p>Add new customer</p></div>
			<div class="clear" style="z-index: 740;"></div>
	</div>
</div>

<div class="content" style="z-index: 730;">
<?php
if($error && !empty($error_msg)){
?>
<div class="albox errorbox" style="z-index: 670;">
	<ul>
<?php
	foreach($error_msg as $err){
		echo "<li>$err</li>";
	}
	echo '</ul><a class="close tips" href="#" original-title="close">close</a></div>';
}
elseif($msg != ''){
?>
<div class="albox succesbox" style="z-index: 690;">
	<b>Success :</b> <?php echo $msg; ?>. 
	<a class="close tips" href="#" original-title="close">close</a>
</div>
<?php
}
?>
<div class="simplebox grid740" style="z-index: 720;">
		<div class="titleh" style="z-index: 710;">
			<h3>Add customer form</h3>
		</div>
		<div class="body" style="z-index: 690;">
		
		  <form action="" method="post" name="form2" id="form2">
		  
			<div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Customer Name</span>	
				<input type="text" style="width:300px" id="customer_name" class="st-forminput" name="customer_name" value="<?php echo $_POST['customer_name'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
		  	<div class="st-form-line" style="z-index: 660;">	
				<span class="st-labeltext">Customer User</span>	
				<input type="text" style="width:200px" id="customer_user" class="st-forminput" name="customer_user" original-title="Customer User for login app later" value="<?php echo $_POST['customer_user'] ?>"> 
			<div class="clear" style="z-index: 650;"></div>
			</div>
			<div class="st-form-line" style="z-index: 660;">	
				<span class="st-labeltext">Password</span>	
				<input type="password" style="width:200px" id="customer_password" class="st-forminput" name="customer_password"> 
			<div class="clear" style="z-index: 650;"></div>
			</div>
		  
			<div class="st-form-line" style="z-index: 660;">	
				<span class="st-labeltext">Re-type Password</span>	
				<input type="password" style="width:200px" id="customer_password2" class="st-forminput" name="customer_password2"> 
			<div class="clear" style="z-index: 650;"></div>
			</div>
			
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Address</span>	
				<input type="text" style="width:500px" id="address" class="st-forminput" name="address" value="<?php echo $_POST['address'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">TelePhone</span>	
				<input type="text" style="width:100px" id="telephone" class="st-forminput" name="telephone" value="<?php echo $_POST['telephone'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">CellPhone</span>	
				<input type="text" style="width:100px" id="cellphone" class="st-forminput" name="cellphone" value="<?php echo $_POST['cellphone'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
			<div class="st-form-line" style="z-index: 660;">	
				<span class="st-labeltext">Email</span>	
				<input type="text" style="width:300px" id="customer_mail" class="st-forminput" name="customer_mail" value="<?php echo $_POST['customer_mail'] ?>"> 
			<div class="clear" style="z-index: 650;"></div>
			</div>
			
			<div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Nick Chat</span>	
				<input type="text" style="width:300px" id="nick" class="st-forminput" name="nick" value="<?php echo $_POST['nick'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
            
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Bank Name</span>	
				<input type="text" style="width:300px" id="bank_name" class="st-forminput" name="bank_name" value="<?php echo $_POST['bank_name'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
            
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Bank Address</span>	
				<input type="text" style="width:500px" id="bank_add" class="st-forminput" name="bank_add" value="<?php echo $_POST['bank_add'] ?>"> 
			<div class="clear" style="z-index: 670;"></div>
			</div>
            
            <div class="st-form-line" style="z-index: 680;">	
				<span class="st-labeltext">Bank Number</span>	
				<input type="text" style="width:200px" id="bank_num" class="st-forminput" name="bank_num" value="<?php echo $_POST['bank_num'] ?>">
			<div class="clear" style="z-index: 670;"></div>
			</div>
			
                       
			<!-- This is uniform selectbox - view this item class -->
			<div class="st-form-line" style="z-index: 640;">	<span class="st-labeltext">Status</span>	
			<div id="uniform-select1">
			<select id="select1" name="status">
			  <option value="0">Off</option>
			  <option value="1">On</option>
			</select>
			</div>
				<div class="clear" style="z-index: 630;"></div> 
			</div>
			
			
			<div class="button-box" style="z-index: 460;">
			  <input type="submit" class="st-button" value="Submit" id="button" name="button">
			  <input type="reset" class="st-clear" value="Reset" id="button2" name="button">
			</div>
			
		  </form>
		  
		</div>
	</div>
</div>
</div>